‘Better taking the risk than a lifetime punishment of early forced marriage’: Young people’s perceptions and experiences towards voluntary termination of pregnancy in northern Mozambique

•While early pregnancy is a shame, forced marriage is an accepted corrective action.•Fear of forced marriage and illicit charges at health facilities prevents safe VTP.•Male partners are crucial in providing financial support for girls’ access to VTP.•Despite not being legal, self-managed medical abortion is widely used in practice.•Age-restrictive laws for adolescents have implications on access to safe abortion. This study aimed to explore young people’s perceptions and experiences on access to voluntary termination of pregnancy (VTP) in northern Mozambique. A qualitative study of twelve focus group discussions was conducted from June to September 2021 in Nampula province, northern Mozambique. A total of 94 purposively selected 15–24-year-old males and females participated in the study. Data was inductively coded and reflexive thematic analysis inspired by Braun and Clarke was applied. Socio-Ecological theory was used to frame the discussion. Despite VTP being decriminalized and by law to be provided free of charge, unsafe abortion remains a common choice among young people towards unintended pregnancy. Barriers to help-seeking access to safe VTP include: 1) fear, 2) sociocultural gendered norms and power dynamics, 3) lack of VTP service provision at nearest health facilities, and 4) unaffordable services where available. Fear associated with early forced marriage, a parental corrective action towards premarital pregnancy coupled with lack of male financial autonomy to afford illicit charges, remain the most important factors preventing young people seeking for help at family and safe VTP services at facility level. Amidst multiple barriers in accessing health services, unsafe abortion is viewed by young people as a better option than facing a lifetime punishment of early forced marriage, a common parental corrective action towards premarital pregnancy.